Dynamic Chiropractic - August 15, 1996, Volume 14, Issue 17|
Confusion vs. Illusion
Vaccination Is Not Our Real DebateA recent Dynamic Chiropractic article by Dr. Tedd Koren, "Confused about Vaccination? Don't Read JMPT!" (June 3, 1996 issue) challenges the conclusions drawn by Drs. Fred Colley and Mitch Haas in their JMPT article, "Attitudes on Immunization: A Survey of American Chiropractors." Dr. Koren criticizes Drs. Colley and Haas, their interpretations, their references, and even their philosophy. Having enough other fish to fry, and little interest in this "debate," I nonetheless would like to offer some comments as someone who has credentials in both fields concerned: chiropractic and public health.
Neither Koren/Coulter nor Colley/Haas has offered us a comprehensive review of the accepted literature on vaccination. Selected references, biases studies, renegade authors (PhDs, MDs, DCs), and political propaganda do not help to clarify an issue but rather further muddy the waters.
Certainly all the evidence is not yet in. Is it ever? Certainly there are risks inherent in vaccination (and in everything else), but right now a comprehensive review of the scientific literature would show that the overwhelming preponderance of evidence shows vaccination to be relatively safe and effective for its purposes when administered to the general public: not risk free, not without some adverse effects, not "immune" from ongoing research and further investigation. But as far as we can prove right now, it is an acceptable public health intervention/practice with an adequate scientific basis. Whether vaccination, no-smoking campaigns, AIDS education programs, etc., the chiropractic profession should support public health programs in principle, although not necessarily without reservation.
My own opinion is that the following could be a noncontroversial statement that any chiropractic doctor would be able to support without compromising their integrity:
The rate of adverse effects to immunization is small, but still tragic to those who suffer them. In an ideal world researchers could find simple, safe, inexpensive screening tests to identify those at higher risk for adverse effects who then would be excluded from vaccines that are safe for the general population.
I also think a pre/post-immunization spinal adjustment should be given to everyone to neutralize some of the vaccination discomfort and minor side effects that often occur. (Admittedly I have no research other than clinical anecdotes to support this idea).
But in another sense I have some sentiment that this "debate" is an illusion, a time-and-energy wasting non-issue for chiropractors. Perhaps both have missed the crux of the immunization issue. Perhaps since we are chiropractors we should be concerned less about whether a person is immunized or not, and more about whether a person is getting regular spinal adjustments or not. Perhaps after all it would be a lot better for us to be pro-active on purer chiropractic issues, rather than being negative and reactive to proven measures of public health prevention, i.e., we should be pro-spinal adjustment; pro-removal of nerve interference; pro-restoration of normal joint biomechanics; pro-subluxation detection; pro-chiropractic research, etc., rather than spending precious resources being anti-vaccination; anti-immunization; anti-fluoridation; anti-pasteurization; anti-vivisection; or anti-any-other-secondary/non-chiropractic issue.
Perhaps we should leave most immunization issues to the public health experts, and concentrate our expertise on providing spinal adjustments to a larger proportion of the public. Drs. Colley and Haas are among those experts who have dual credentials, professional training and formal experience in both chiropractic and public health. Their article and other contributions have helped chiropractic's efforts to establish our credibility with mainstream public health activities. Dr. Koren has rightfully called our attention to some possible short-comings, and reminded us that science requires ongoing vigilance, but done so in a divisive manner; the "confusion" is not clarified by creating an opposite illusion. And yes, we should read JMPT, and other literature, with a scientifically critical and skeptically analytical eye.
Rand Baird, DC, MPH, FICA, FICC